重组人血管内皮抑制素联合顺铂对恶性胸腔积液患者免疫功能和预后生存的影响

Effect of Recombinant Human Endostatin Combined with Cisplatin on Immune Function and Prognostic Survival in Patients with Malignant Pleural Effusion

目的:探究重组人血管内皮抑制素联合顺铂灌注化疗对恶性胸腔积液患者免疫功能和预后生存的影响。方法:选取2019年1月—2021年1月常熟市第二人民医院收治的108例恶性胸腔积液患者,按照随机数表法分为研究组和对照组,各54例。对照组选用顺铂灌注治疗,研究组在对照组基础上联用重组人血管内皮抑制素治疗。比较两组临床疗效、免疫功能指标、不良反应发生率和预后生存质量。结果:研究组客观缓解率(ORR)高于对照组,差异有统计学意义(P<0.05)。研究组恶心呕吐、肝肾功能损害及关节肌肉疼痛等不良反应总发生率均低于对照组,差异有统计学意义(P<0.05)。化疗前,两组免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、负性协同刺激分子B7-H4水平比较,差异无统计学意义(P>0.05);化疗后,两组IgA、IgM高于化疗前,负性协同刺激分子B7-H4水平低于化疗前,且研究组IgA、IgM水平高于对照组,负性协同刺激分子B7-H4水平低于对照组,差异有统计学意义(P<0.05)。研究组总生存时间和无进展生存期长于对照组,差异有统计学意义(P<0.05)。化疗前,两组卡氏评分(KPS)比较,差异无统计学意义(P>0.05);化疗后,研究组KPS评分高于对照组,差异有统计学意义(P<0.05)。结论:重组人血管内皮抑制素联合顺铂灌注化疗治疗恶性胸腔积液的效果显著,可有效改善患者生存质量和免疫功能,缓解负性协同刺激机制影响,并降低治疗不良反应的发生风险,具有更好的临床疗效和安全性。

Objective:To explore the effect of Recombinant Human Endostatin combined with Cisplatin infusion chemotherapy on immune function and prognostic survival of patients with malignant pleural effusion.Method:A total of 108 patients with malignant pleural effusion admitted to the Changshu Second People's Hospital from January 2019 to January 2021 were selected and divided into study group and control group according to random number table method,with 54 patients in each group.The control group was treated with Cisplatin infusion chemotherapy,while study group was treated with Recombinant Human Endostatin on the basis of control group.The clinical efficacy,immune function indexes,incidence of adverse reactions and prognostic survival quality of the two groups were compared.Result:The objective response rate(ORR)of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).The total incidence of nausea and vomiting,liver and kidney function damage and joint muscle pain in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Before chemotherapy,there were no significant differences in the levels of immunoglobulin A(IgA),immunoglobulin M(IgM)and negative co-stimulatory molecule B7-H4 between the two groups(P>0.05).After chemotherapy,the levels of IgA and IgM in the two groups were higher than those before chemotherapy,and the levels of negative co-stimulatory molecule B7-H4 were lower than those before chemotherapy,and the levels of IgA and IgM in the study group were higher than those in the control group,and the level of negative co-stimulatory molecule B7-H4 was lower than that in the control group,and the differences were statistically significant(P<0.05).The overall survival time and progression-free survival time of the study group were longer than those of the control group,and the differences were statistically significant(P<0.05).Before chemotherapy,there was no statistically significant difference in Karnofsky(KPS)score between the two groups(P>0.05).After chemotherapy,the KPS score in the study group was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Recombinant Human Endostatin combined with Cisplatin infusion chemotherapy has a significant effect in the treatment of malignant pleural effusion,which can effectively improve the quality of life and immune function of patients,alleviate the influence of negative co-stimulation mechanism,and reduce the risk of adverse treatment reactions,with better clinical efficacy and safety.